Mn 566 Midterm Exam 2022

Data from the Framingham Heart study suggests that individuals who are normotensive at 55 years of age have how much lifetime risk of developing hypertension? A. 65% B 75% C. 80% D. 90% - ANSWER D. 90% Mary has hy ...

Data from the Framingham Heart study suggests that individuals who are normotensive at 55 years of age have how much lifetime risk of developing hypertension? A. 65% B 75% C. 80% D. 90% - ANSWER D. 90% Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her? A. Chlorthalidone B. Metoprolol C. Amlodipine D. Losartan - ANSWER A. Chlorthalidine A delta wave on an ECG may be present in which condition? A. Prinzmetal's Angina B. Bundle Branch Block C. Wolff-Parkinson-White Syndrome D. Aortic Stenosis - ANSWER C. Wolff-Parkinson-White Syndrome Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: A. Severe Asthma B. A common valvular lesion C. Severe hypertension D. Prosthetic heart valve - ANSWER D. Prosthetic heart valve There are 4 stages of heart failure classified as A to D, that describe the evolution and progression of disease. In which stage are patients hospitalized or treated with specialized interventions or hospice care for refractory symptoms of heart failure despite medical treatment? A. Stage A B. Stage B C. Stage C D. Stage D - ANSWER D. Stage D Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? A. Brain Natriuretic Peptide B. C-Reactive Protein C. Serum Albumin D. Erythrocyte Sedimentation Rate - ANSWER A. Brain Natriuretic Peptide If a pulmonary embolus is suspected, which testing should be performed? A. Ultrasound B. MRI C. V/Q Scan D. D-Dimer - ANSWER A. V/Q Scan Which of the following medications can cause hyperlipidemia? A. High Dose Diuretics B. Exercising 30 minutes every day C. Hyperthyroidism D. Angiotensin II Receptor Blocker - ANSWER A. High Dose Diuretics In which patient do premature ventricular contractions NOT need to be treated? A. Kelly, a 25-year-old female with an allergy to bee stings B. Mary, a 50-year-old female with a history of untreated anxiety C. Randy, a 45-year old male with history of htn. D. Bill, 65-year-old with history of angina - ANSWER A. Kelly, a 25-year-old female with an allergy to bee stings What is the most common form of heart disease in a patient with atrial fibrillation? A. Hypertension B. Rheumatic Heart Disease C. Angina D. Coronary Artery Disease with heart failure - ANSWER D. Coronary Artery Disease associated with heart failure What does digitalis compete with at binding sites on the cell membrane? A. Magnesium B. Potassium C. Sodium D. Calcium - ANSWER B. Potassium Which of the following will help a provider determine whether a patient is experiencing paroxysmal supraventricular tachycardia (PSVT) or ventricular tachycardia (VT)? A. Obstructed P wave B. Ability to calculate PR interval C. Frog Sign D. Chvostek's Sign - ANSWER C. Frog Sign The hallmark of an absence seizure is: a. No activity at all. b. A blank stare. c. Urine is usually voided involuntarily. d. The attack usually lasts several minutes. - ANSWER B. Blank Stare Which of the following fits the classic description of a patient with multiple sclerosis? A. Teenage Male B. 65 year-old male C. 25 year-old female D. 60 year-old female - ANSWER C. 25 year-old female Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help decrease edema in the labyrinth of the ear? A. Meclizine B. Diphenhydramine C. Diamox D. Promethazine - ANSWER C. Diamox Gabby, age 22, has Bell's Palsy on the right side of her face. Her mouth is distorted and she is concerned about permanent paralysis and pain. What do you tell her? A. "Most patients have complete recovery in 3-6 months" B. "Unfortunately, you'll probably have a small amount of residual damage." C. "Don't worry, I'll take care of everything." D. "You may have a few more episodes over your lifetime, but no permanent damage." - ANSWER A. "Most patients have complete recovery in 3-6 months" About 90% of all headaches are: A. Tension B. Migraine C. Cluster D. Without pathological cause - ANSWER D. Without pathological cause Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help if given IV once a month? A. Glatiramer Acetate B. Natalizumab C. Fingolimod D. Glucocorticoids - ANSWER B. Natalizumab A score of 12 to 24 on this test indicates intermediate Alzheimer's: A. SLUMS B. MoCA C. FAST D. MMSE - ANSWER D. MMSE IV thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset? A. 1 hour B. 3 hours C. 6 hours D. 12 Hours - ANSWER B. 3 Hours Which of the following should be started promptly if viral encephalitis is suspected? A. Oral amoxicillin B. IV acyclovir C. IV ampicillin D. Oral acyclovir - ANSWER B. IV acyclovir When a patient has a carotid bruit, which of the following should the PCP gather from the patient history? A. History of hemophilia B. History of peripheral vascular occlusive disease C. History of seizure disorder D. History of sickle cell disease - ANSWER B. History of peripheral vascular occlusive disease Which patient is most likely to have myasthenia gravis (MG)? A. A 75 year-old Caucasian Woman B. A 31 year-old Hispanic woman C. A 55-year-old African American male D. A 10-year-old Middle Eastern male - ANSWER B. A 31-year-old Hispanic Woman Which patient is most likely to be diagnosed with Guilllan-Barre Syndrome? A. A 6-month-old infant B. A 30-year-old man C. A 72-year-old woman D. A 50-year-old man - ANSWER C. A 72-year-old woman Which of the following persons fit the classic description of a patient with multiple sclerosis (MS)? A. A teenage male B. A 65-year-old male C. A 25-year-old female D. A 60-year-old female - ANSWER C. A 25-year-old female Jolene has breast caner that has been staged as T1, N0, M0. What might this mean? A. The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated. B. The cancer is in situ; it is spreading into the lymph nodes but the spread cannot be evaluated otherwise. C. The cancer is less than 3cm in size and has not spread to the lymph nodes or other parts of the body. D. The cancer is about 5cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading. - ANSWER C. The cancer is less than 3cm in size and has not spread to the lymph nodes or other parts of the body. Which of the following conditions is associate with cigarette smoking? A. Glaucoma B. Increased sperm quality C. Bladder Cancer D. Eczema - ANSWER C. Bladder Cancer The barrel-chest characteristics of emphysema is a result of: A. Chronic Coughing B. Hyperinflation C. Polycythemia D. Pulmonary Hypertension - ANSWER B. Hyperinflation Your patient is on theophylline for his asthma. You want to maintain his serum levels between: A. 0 to 5 mcg/mL B. 5 to 10 mcg/mL C. 5 to 15 mcg/mL D. 10 to 20 mcg/mL - ANSWER C. 5 to 15 mcg/mL Which ethnic group has the highest lung-cancer incidence and mortality rate? A. African American Men B. Scandinavian men and women C. Caucasian women D. Asian Men - ANSWER A. African American men Marta is taking TB drugs prophylactically. How do you instruct her to take them? A. Take them on an empty stomach to facilitate absorption. B. Take them with aspirin (ASA) to prevent flushing? C. Take them with ibuprofen to prevent a headache. D. Take them with food to prevent nausea. - ANSWER A. Take them on an empty stomach to facilitate absorption. What is the most common cause of CAP? A. Streptococcus pneumoniae B. Klebsiella pneumoniae C. Legionella pneumoniae D. Pseudomonas aeruginosa - ANSWER A. streptococcus pneumoniae Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking? A. Inhaled corticosteroid B. Leukotriene-receptor antagonist C. Systemic Corticosteroid D. Methylxanthines - ANSWER A. Corticosteroids Madeline is a smoker in a primary-care visit with her provider. After her provider asks if she is willing to quit, she says she has decided to quit, has bought nicotine gum, and is interested in hearing about Chantix. Which of the following steps is Madeline in regarding behavior changes and her attempts at cessation? A. Precontemplation B. Action C. Maintenance D. Preparation - ANSWER D. Preparation Amy has a history of lung cancer and is experiencing new-onset right side ptosis and miosis and says, "I'm so hot, but I'm not sweating." Which of the following conditions can be attributed to her new-onset symptoms? A. Bell's Palsy B. Turner's Syndrome C. Murphy's Syndrome D. Horner's Syndrome - ANSWER D. Horner's Syndrome Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD? A. 3 Hours B. 6 Hours C. 11 Hours D. 15 Hours - ANSWER D. 15 Hours Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis? A. Asthma B. Emphysema C. Chronic Bronchitis D. Influenza - ANSWER C. Chronic Bronchitis The patient has hyperosmolar hyperglycemic syndrome. Which laboratory findings would the clinician observe? A. Plasma bicarbonate 8 mEq/L B. Blood glucose level 40 mg/dL C. Serum osmolality 420 mOsm/kg D. Blood pH 7.20 - ANSWER C. Serum osmolality 420 mOsm/kg The clinician is assessing for the most common cause of increased neck size. Which area would the clinician exam? A. Salivary Glands B. Lymph nodes C. Thyroid D. Trachea - ANSWER C. Thyroid Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She is also having problems sleeping at night. On physical examination, the clinician finds an irregular heartbeat and hyperactive reflexes. The differential diagnosis should include which condition? A. Myxedema B. Thyrotoxicosis C. Cushing's Syndrome D. Pan-hypopituitarism - ANSWER B. Thyrotoxicosis After removing a tack from a type 2 diabetic's heel and evaluating the site for infection, what is the best plan for this patient? A. Suggest the patient use a heating pad to improve circulation. B. Refer to a podiatrist for a foot-care treatment plan. C. Send the patient for acupuncture treatment. D. Recommend increased intake of vitamin B12. - ANSWER B. Refer to a podiatrist for a foot-care treatment plan. Which hydrocortisone dose would the clinician prescribe for a patient with Addison's disease? A. 25 to 50 mg daily B. 0.5 to 0.2 mg daily C. 20 mg in the morning and 10mg in early evening D. 2 to 4mg in the morning and 1 to 2mg in the evening. - ANSWER C. 20mg in the morning and 10mg in early evening. Which instruction should the clinician include in patient teaching regarding management of obesity? A. Occasionally skipping meals is acceptable. B. Try to use nonstick cookware when baking or frying. C. High-intensity physical activity is recommended D. Exercise for about 100 minutes per week - ANSWER B. Try to use nonstick cookware when baking or frying Which question should the clinician ask to determine the most frequent cause of diabetic ketoacidosis? A. "How often are you taking your insulin?" B. "Which type of infection have you experienced recently?" C. "What type of diet have you been following?" D. "Is there any reason you don't like taking your medications?" - ANSWER B. "What type of infection have you experienced recently?" A male patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first? A. Administer glucagon subcutaneously. B. Have him drink 4 ounces of juice C. Call 911 D. Ask him about his usual eating habits - ANSWER B. Have him drink 4 ounces of juice Which action would the clinician take to elicit Chvostek's sign? A. Check serum level of glucose after drinking a glass of juice. B. Tap the facial nerve below the zygomatic arch anterior to the earlobe. C. Press into the lower quadrant of the abdomen and release quickly D. Pump a blood pressure cuff 20 mm Hg about the patient's systolic pressure - ANSWER B. Tap the facial nerve below the zygomatic arch anterior to the earlobe Which of the following is a common sign of type 2 DM? A. Anorexia B. Recurrent yeast infection C. Fluid overload D. Elevated high-density lipoprotein cholesterol - ANSWER B. Recurrent yeast infection A male patient with diabetes asks the clinician why he needs to check his blood sugar at home even when he feels good. Which response by the clinician would be most appropriate? A. "Control of glucose will help postpone or delay complications." B. "Regularly checking blood sugar will help you" C. "Monitoring glucose will promote a sense of connectedness."